I received a copy of Falling into the Fire by psychiatrist Christine Montross through a Goodread’s First Read give away.
I was touched and awed by this book. Ms. Montross shares her experiences as a psychiatrist at an in-patient hospital. Her experience in getting to know her patients, sometimes with detailed case notes, other times having to prize information from the patient, peeling away at their experiences, stories and symptoms to come up with a diagnosis and treatment plan. Ms. Montross shares with the readers her successes and failures and her frustration with trying to help individuals for which medicine doesn’t have clear answers, admitting to her powerlessness and limitations of her speciality.
As a family member of someone with a severe mental illness it was an eye opener to read these stories. It was refreshing to read a very optimistic and dedicated doctor be honest about not having all the answers, being honest about how treatment is often a practise in addition and elimination until a workable solution is found.
I have found other literature about mental illness to be unnaturally optimistic about diagnosis, treatment and outcomes, upbeat “how-to” guides, or memoires by patients who have found a level of “normal”. This is the first book I have read that dealt honestly with the frustration, the impotence, the revolving cycle of success to failure to success, the lifelong burden these patients and their families carry. Having a psychiatrist express frustration with patients, frustration with the limitations of medicine when dealing with mental illness, frustration with less than ideal outcomes for her patients was so humanizing and honest. As a family member I have felt the same frustrations and reading her accounts, I felt validated that my feelings were not a sign of giving up, but rather a normal expression to a challenging situation. Ms. Montross’s example of
continuing to work in this profession, continuing to find a care plan gives me hope.
Since her patients come to her admitted into the hospital, she doesn’t follow them as outpatients which leaves the reader without a clear resolution. Some readers might see this as a weakness. However, I see it as a realistic representative of mental health treatment. Patients with severe mental illnesses are frequently diagnosed when their behaviour brings them through the door of an ER into a hospital admission. Once stabilized they are sent out the door clutching prescriptions, and follow-up contacts for on-going treatment, expected to navigate the labyrinth alone if they do not have family to assist. Patients who can, at most, hope for control, without the expectation of a cure.
Well written, fascinating, a very intimate portrait of treating mental illness.